糖尿病对高脂血症急性胰腺炎的影响

The effects of diabetes on hyperlipidemic acute pancreatitis

目的探讨糖尿病对高脂血症急性胰腺炎病情的影响。方法回顾性分析1996年6月至2006年6月收治的96例高脂血症急性胰腺炎患者的临床资料。结果96例患者中，重症急性胰腺炎21例（21．9％），轻度急性胰腺炎75例（78．1％），其中诊断为糖尿病患者24例（25％），无糖尿病患者72例（75％）。糖尿病史组甘油三酯水平、肥胖例数、重症急性胰腺炎例数和APACHEⅡ评分与无糖尿病史组比较差异均具有统计学意义（P〈0．05）。Cox模型分析显示，血糖水平、糖尿病病史长短、甘油三酯水平和肥胖是影响高脂血症急性胰腺炎预后的独立因素。APACHEⅡ评分与患者的血糖水平呈正相关，降糖治疗在短期内对患者的血脂水平无明显影响。结论血糖水平和高脂血症急性胰腺炎的严重程度相互影响，糖尿病病史一定程度上影响高脂血症急性胰腺炎病情的进展。

Objective To investigate the effect of diabetes on hyperlipidemic acute pancreatitis. Methods The clinical data of 96 patients with hyperlipidemie acute pancreatitis from Jun 1996 to Jun 2006 were retrospectively reviewed. Results Of all 96 patients, 21.9% （21/96） suffered from severe acute panereatitis （ SAP ）, 78.1% （ 75/96 ） suffered from mild acute pancreatitis （ MAP ） , respectively. Twenty-four patients （25%） were diabetics. Triglyceride level, obesity rate, SAP cases and APACHE II scores in patients with diabetes were significantly higher than those of no-diabetes patients（P 〈 0. 05 ）. The glucose level, diabetes of history length, triglyeeride level and fat were the independent factors for prognosis of acute pancreatitis with hyperlipidemia by the Cox model analysis. With the increasing of APACHE II score, the blood glucose level of patients increased. Blood glucose level in a short period of time does not correlate with lipid levels. Conclusions The level of blood glucose is related with hyperlipidemic acute pancreatitis, the history of the diabetes to a certain extent influences the development of hyperlipidemie acute pancreatitis.